Individual
MARY ANN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2109 NAVAJO BLVD, HOLBROOK, AZ 86025-0000
(928) 524-2851
(928) 524-2171
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 213-6121
(928) 774-6687
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2186
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
446452
—
AZ
Enumeration date
11/07/2005
Last updated
09/14/2011
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